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Surgical Endoscopy
Published in: Surgical Endoscopy 10/2020

01-10-2020 | Gastric Fundoplication | Review Article

Mesh-related complications in paraoesophageal repair: a systematic review

Authors: Calista Spiro, Natalie Quarmby, Siva Gananadha

Published in: Surgical Endoscopy | Issue 10/2020

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Abstract

Background

Paraoesophageal hernias (PEH) have a high recurrence rate, prompting surgeons to consider the use of mesh reinforcement of the hiatus. The risks and benefits of mesh augmentation in PEH repair are debated. Mesh-related complications including migration and erosion are considered in this publication.

Design

A systematic literature review of articles published between 1970 and 2019 in Medline, OVID, Embase, and Springer database was conducted, identifying case reports, case series and observational studies of PEH repair reporting mesh-related complications.

Results

Thirty-five case reports/series of 74 patients and 20 observational studies reporting 75 of 4200 patients with mesh complications have been included. The incidence of mesh-related erosions in this study is 0.035%. PTFE, ePTFE, composite and synthetic meshes were frequently associated with mesh erosion requiring intervention. Complete erosions are often managed endoscopically while partial erosions may require surgery and resection of the oesophagus and/or stomach.

Conclusions

Mesh-related complication is rare with dysphagia a common presenting feature. Mesh erosion is associated with synthetic mesh more frequently in the reported literature. A mesh registry with long-term longitudinal data would help in understanding the true incidence of mesh-related complications.
Appendix
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Metadata
Title
Mesh-related complications in paraoesophageal repair: a systematic review
Authors
Calista Spiro
Natalie Quarmby
Siva Gananadha
Publication date
01-10-2020
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 10/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-020-07723-0

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